Short guideline for endometriosis

I have endometriosis

short guidelines


Without a laparoscopy

If a laparoscopy is planned, you need to check

  • A cystic ovarian endometriosis of more than 6 cm needs surgery in 2 steps otherwise the ovary risks to be destroyed.
  • If a large deep endometriosis is suspected, hydronefrosis  (e.g. with  ultrasound) and bowel stenosis (with a contrast enema) need to be excluded before surgery
  • An ureter stent is indicated only in cases of hydronefrosis
  • Check the level of expertise of the surgeon and the percentage of bowel resections performed. A bowel resection is rarely needed  (<10%) and should be decided during surgery. Too often avoidable bowel resections are performed.

Surgery was not performed during the laparoscopy

  • The diagnosis is probably correct
  • Check the photo’s or video to ascertain that all has been checked such as  appendix, the sigmoid and diaphragm
  • This is correct; if lesions were unexpectedly severe it is better not to do surgery without the required expertise.

If surgery was performed,  you should know at least.

  • the type of intervention and the type of endometriosis
  • complete or incomplete excision  ?
  • complications  ?
  • duration of surgery ?
  • video or at least photo-documentation ?

Medical treatment was started without a  laparoscopy, thus without a diagnosis

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